Heart Treatments

  1. Atropine
    What does it do?
    *Picks-Up-the Pace

    *Increases HR in sinus bradycardia & heart blocks
  2. Atropine
    *Assess for: chest pain after administration, monitor HR and rhythm

    *Note: Increasin HR increase cardiac workload and O2 demand
  3. Atropine an anticholinergic agent
    Physostigmine: cholinergic alkaloid
  4. Diltiazem (Cardizem)
    Calcium channel blocker
  5. Class IV - Calcium Channel Blockers -> Diltiazem (Cardizem)
    • *Slows flow of Ca in heart cells and vascular smooth muscle cells.
    • *Slows conduction through SA & AV nodes (atrial arrhythmias).
    • *Decrease HR.
    • *Used in atrial fib/flutter with a rapid ventricular response, tachydysrhythmics, and SVT.
  6. Class IV - Calcium Channel Blockers -> Diltiazem (Cardizem)
    • *Bradycardia
    • *Hypotension (b/c prevent vascular constriction)
    • *S/S of HF (causes heart block)
    • *Peripheral edema (*Benign ankle edema)

    Careful giving with Beta-Blocker & Digoxin
  7. Class I - Sodium Channel Blocker -> Lidocaine
    *CNS; confusion, tremors, drowsiness, seizure
  8. Class I - Sodium Channel Blocker ->Lidocaine
    • *Sodium Channel Blocker
    • *Shortens replorization phase
  9. Class I - Sodium Channel Blocker ->
    Class C - Rhythmol, Tambocor
    • Increase or potentites effects of warfarin.
    • Contraindicated in pt's with AICDs (require more energy to get pt's out of lethal arrhythmias).
  10. Class II - Beta-Blockers
    • Can be cardio or noncardio selective.
    • Blocks Beta Receports in the Heart Causing.
    • *Decrease HR
    • *Decrease force of contraction.
    • *Decrease rate of A-V Conduction

  11. Class II - Beta-Blockers
    • Bradycardia (increase if given with other negative chronotropes - synergistic effect)
    • Lethargy
    • GI Distrubance
    • Decrease BP
    • Depression
    • ***Potentiate HF
  12. Class II - Beta-Blockers -> Sotolol
    Used for ATRIAL arrhythmias ONLY
  13. Class III - K Channel Blocker -> Codarone (Amiodarone)
    • Decreases cardiac conduction & automaticity
    • Lengthen Refractory Period; doesn't effect Na channel
    • PRI & QT prolonged
    • First line for ventricular arrhythmias - VT, life-threatening VF, Torsades
    • Second line for atrial dysrhythmias
    • Long half-life (30-60 days)
    • Potentiates digoxin and coumadin
  14. Class III - K Channel Blocker -> Codarone (Amiodarone)
    • 2x/year: Monitor labs q6 months for hypothyroidism (TSH, T4), LFT (AST, ALT).
    • Drug levels need to be monitored q3-6 months.
    • Yearly chest x-ray & pulmonary function test.
    • Yearly opthamaology visit (visual disturbances).
    • Causes skin sensitivity & can make a "blue mask" with overexposure to the sun.
  15. Class III - K Channel Blocker -> Multaq
    • Used for AF/Flutter with RVR
    • Benefit: not as many SE as does Amiodarone
  16. Class III - K Channel Blocker -> Multaq
    • FDA warning R/T dronaderone causing elevation of LFT & bilirubin especially during the first 6 months of therapy.
    • Black Box Warning: Pt's with decompensated HF and are on a dronaderone had a greater than twofold increase in mortality. The use of dronaderone is contraindicated in pt's with NYHC IV or recently decompensated NYHC II or III.
  17. Class III - K Channel Blocker -> Amiodarone, Tikosyn, Multaq
    • Commonly given to convert a pt. from A-fib/flutter with RVR back to SR.
    • May also be given to patients who require cardioversion to SR or have recently cardioverted, to maintain SR.
  18. Betapace (Sotolol)
    • Part anti-dysrhythmic & part beta-blocker & is not a first line drug; used when other antiarrhythmic medications have failed.
    • Non-cardio selective.
  19. Digoxin
    • Improve cardiac contractility which results in decreased end diastolic volume and increased Cardiac Output:
    • Slows HR
    • Increase Contraction
    • Used in A-fib, A-flutter
  20. Digoxin
    • Digitalis Toxicity:
    • N/V, abdominal pain & bloating
    • H/A, fatigue, malaise
    • Flashes of yellow lights, hazy vision, flickering images
  21. Digoxin
    • Potassium levels (hypokalemia) & digitalis
    • Baseline VS
    • Apical pulse (one min.)
    • Many Drug-Drug interaction: don't give with Amiodarone
    • Therapeutic Level: 0.5-2
  22. Digoxin
    • Digibind:
    • Given IV (reverses in 30 min).
    • Reserved for life-threatening overdose in pt's who are in shock or cardiac arrest or have severe ventricular dysrhythmias with a potassium >5 mEq/L.
    • Can cause hypersensitivity reactions.
    • Note: Digoxin CANNOT be restarted until Digibind is eliminated from the body (takes several days in pt's who have normal renal function).
  23. Magnesium Sulfate (not an antiarythmic)
    • Electrolyte used to treat refractory VT or VF
    • Hypomagnesemia causes ventricular irritability
    • Used to treat Torsades that often results from other antidysrhythmics
  24. Unclassified Antiarrhythmic -> Adenocard (Adenosine)
    • The drug for SVT in an emergent situation.
    • Works by slowing conduction through AV node.
    • Doesn't react with other antidysrhythmics like Dig or beta-blockers.
    • Produce bradycardia resistant to atropine.
  25. Pacemakers
Card Set
Heart Treatments
Heart medications and treatments for antiarrhythmics